23D2002335 CLIA NUMBER - RESIDENTIAL HOSPICE

Laboratory Demographics

  • CLIA Code: 23D2002335
  • Facility Name: RESIDENTIAL HOSPICE
  • Facility Address: 5440 CORPORATE DRIVE SUITE 400
    TROY, MI
    ZIP 48098
  • Facility Phone: 866 902-5854
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: WENDY R. BONGERO
  • NPI Number: 1891164554
  • Taxonomy: 363LA2200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 23D2002335
LAB Type Home Health Agency
Facility Name RESIDENTIAL HOSPICE
Street 5440 CORPORATE DRIVE SUITE 400
City TROY
State MI
ZIP 48098
Phone 866 902-5854
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/13/2024
Certificate Expiration Date 1/12/2026
Facility Type Home Health Agency
Lab Director WENDY R. BONGERO

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This page was last updated on: 9/29/2025